Individual provider Active NPI

Michele Marie Brock, NP

  • Gerontology Nurse Practitioner
  • Portage, MI
National Provider Identifier
1003269192
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN11018201 Issued in MI
Practice address
2725 Airview Blvd Ste 105
Portage, MI 49002-1804
Phone
(269) 349-8386
NPI assigned
Jul 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN11018201 MI Primary

Addresses

Primary practice location

2725 Airview Blvd Ste 105
Portage, MI 49002-1804

Mailing address

PO Box 40412
Belfast, ME 04915-1255
Phone (269) 349-8386

Other practice location 1

1021 Hill St Ste 100
Three Rivers, MI 49093-2744
Phone (269) 273-8511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180531001654 MI Practitioner - Nurse Practitioner 2264709526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vpa PCGroup PAC ID 9234041948, 181 clinicians

Practice addresses (Care Compare)

Portage, MI 49002
Phone (269) 349-8386

Hospital & facility affiliations

  • Elara Caring Home health agency, Jackson, MI, CCN 237274
  • Three Rivers Health Hospital, Three Rivers, MI, CCN 230015
  • Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11018201MIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Three Rivers Area Medical Associates PC Past Accepting new patients
Lakeland Community Hospital Watervliet Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mstrebeck6597@lakeland.midirect.net
  • Direct secure messaging: michele.brock@614891986485252.direct.elationemr.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1003269192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40412",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049151255",
            "telephone_number": "269-349-8386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 AIRVIEW BLVD STE 105",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490021804",
            "telephone_number": "269-349-8386"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1021 Hill St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Three Rivers",
            "state": "MI",
            "postal_code": "490932744",
            "country_code": "US",
            "telephone_number": "269-273-8511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROCK",
        "first_name": "MICHELE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-13",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "APRN11018201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

Verify at the official NPI Registry.